MMWR Morb Mortal Wkly Rep. 2020 Nov 6;69(44):1625-1630. doi: 10.15585/mmwr.mm6944a3.
Correctional and detention facilities have been disproportionately affected by coronavirus disease 2019 (COVID-19) because of shared space and movement of staff members and detained persons within facilities (1,2). During March 1-April 30, 2020, at Cook County Jail in Chicago, Illinois, >900 COVID-19 cases were diagnosed across all 10 housing divisions, representing 13 unique buildings. Movement within the jail was examined through network analyses and visualization, a field that examines elements within a network and the connections between them. This methodology has been used to supplement contact tracing investigations for tuberculosis and to understand how social networks contribute to transmission of sexually transmitted infections (3-5). Movements and connections of 5,884 persons (3,843 [65%] detained persons and 2,041 [35%] staff members) at the jail during March 1-April 30 were analyzed. A total of 472 (12.3%) COVID-19 cases were identified among detained persons and 198 (9.7%) among staff members. Among 103,701 shared-shift connections among staff members, 1.4% occurred between persons with COVID-19, a percentage that is significantly higher than the expected 0.9% by random occurrence alone (p<0.001), suggesting that additional transmission occurred within this group. The observed connections among detained persons with COVID-19 were significantly lower than expected (1.0% versus 1.1%, p<0.001) when considering only the housing units in which initial transmission occurred, suggesting that the systematic isolation of persons with COVID-19 is effective at limiting transmission. A network-informed approach can identify likely points of high transmission, allowing for interventions to reduce transmission targeted at these groups or locations, such as by reducing convening of staff members, closing breakrooms, and cessation of contact sports.
惩教和拘留设施因工作人员和被拘留者在设施内的共享空间和流动而受到 2019 年冠状病毒病(COVID-19)的不成比例影响(1,2)。2020 年 3 月 1 日至 4 月 30 日,在伊利诺伊州芝加哥的库克县监狱,在所有 10 个住房部门共诊断出 >900 例 COVID-19 病例,涉及 13 个独特的建筑。通过网络分析和可视化检查监狱内的流动情况,该领域检查网络内的要素及其之间的连接。这种方法已被用于补充结核病的接触者追踪调查,并了解社交网络如何促成性传播感染的传播(3-5)。对 3 月 1 日至 4 月 30 日期间监狱内的 5884 人(3843[65%]被拘留者和 2041[35%]工作人员)的流动和联系进行了分析。在被拘留者中发现了 472 例(12.3%)COVID-19 病例,在工作人员中发现了 198 例(9.7%)。在 103701 名工作人员的共享班次连接中,有 1.4%发生在 COVID-19 患者之间,这一比例明显高于单独随机发生的预期 0.9%(p<0.001),表明在该组中发生了额外的传播。仅考虑最初传播发生的住房单元,观察到 COVID-19 被拘留者之间的连接明显低于预期(1.0%对 1.1%,p<0.001),这表明对 COVID-19 患者进行系统隔离可有效限制传播。网络知情方法可以识别可能的高传播点,从而采取干预措施减少针对这些群体或地点的传播,例如减少工作人员会议、关闭休息室和停止接触性运动。